Managers' perspectives of service delivery in public sector nuclear medicine departments in South Africa

Introduction: Nuclear medicine (NM) is a rapidly growing discipline. Across SA, there are 14 and 46 NM departments in the public sector and private sector, respectively. Most SA public sector hospitals are strained because of a lack of adequate resources resulting in delayed bookings and patient waiting lists because of fewer examinations being performed daily. Service contracts between private and public hospitals as a solution for patient access to NM come at a high cost and prove ineffective in curbing the number of unassisted patients. This research aimed to assess the service delivery of NM departments in the public healthcare system from the managers' perspectives. Methodology: This is qualitative research that employed the exploratory research design. The data were collected using a structured interview mostly conducted telephonically. In this research, 11 out of 14 managers in the 14 NM departments from five provinces in SA participated. Interviews were mainly open-ended and centred on addressing shortcomings perceived in ensuring adequate service delivery to public sector NM departments. Results: Three themes pertaining to service delivery in NM emerged, namely barriers affecting service delivery, enablers that influence service delivery, and recommendations to improve service delivery. The majorly devastating findings were on barriers affecting service delivery. These comprised five categories, namely poor service delivery resulting from the unavailability of different resources, poor working conditions, the effects of the COVID-19 pandemic, inadequate management and administration and limited access to NM departments, especially in rural communities. Accolades accomplished by different NM departments were illustrated as enablers. Hardworking departments provided quality NM services for the population and had personnel willing to go the extra mile despite the observed barriers. The recommended solutions were to improve what is available, decentralise services to rural communities, allow personnel who work in the field to implement some of the advances in NM and use of technology and training to improve the services of the NM departments. Conclusion: It was evident from the study that barriers have a devastating impact on service delivery. The unavailability or the lack of key resources was regarded as a major cause of discomfort for healthcare workers and patients. These limitations impact negatively on NM in the clinical setting as a theragnostic department and lead to suboptimal service delivery. There is a lot to be performed at all levels of the healthcare system in order to optimise service delivery on NM in the public healthcare sector. (authors)